Robert Bales May Have Been Psychotic, Says Army's Former Top Psychiatrist Elspeth Ritchie

UPDATE: The Huffington Postrevealed on Sunday that the Pentagon has launched an investigation into the military's use of the anti-malarial drug Lariam, whose possible connection with the Bales' massacre was raised by this post last Tuesday. The Pentagon subsequently denied that the investigation is linked to the massacre, but has refused to say whether Bales was given the drug. The issue has now "exploded," as Ritchie puts it to SW, in a slew of national stories.

As details emerged over the past few days about Staff Sgt. Robert Bales, the once admirable soldier accused of massacring Afghan civilians, the horrific crime became even more unfathomable. Some have suggested that PTSD, or the traumatic brain injury he suffered a couple years ago, might have caused him to snap. But Elspeth Ritchie, the Army's former top psychiatrist, thinks there must be more to it.

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Ritchie, who left her Army post a couple years ago and is now the chief clinical officer for the District of Columbia's mental health department, says PTSD is associated with "hypervigilance, numbing, flashbacks"--but not the "kind of violence Bales that allegedly committed." Similarly, she says TBI commonly causes nausea and dizziness, but not an impulse to massacre women and children.

Instead, Ritchie speculates that Bales may have been having a psychotic episode that left him hearing voices, experiencing delusions or otherwise being out-of-touch with reality. "Maybe he didn't realize that [the victims] were women and children," Ritchie says in an interview with Seattle Weekly. "Maybe he thought they were the Taliban."

If so, she says one possible suspect for his mental state could be the anti-malarial drug Lariam. The military has stopped routinely handing the drug out to soldiers, as it once did, but still dispenses the drug on occasion, according to Ritchie.

The drug, Ritchie says, "has been blamed for all kinds of things," including hallucinations, suicidal thoughts and at least one wife-killing that occurred at Fort Bragg several years back by a solider who had been given the drug.

The crazy-making power of Lariam is brought home by a 2009 CBS News report , which tells of how an American tourist transformed on an African safari after taking the drug.

"She just became completely psychotic in the van," said her husband, who related how his wife had started taking her clothes off and talking about calling people back from the dead. The woman herself, after spending a month in a psychiatric hospital, said she had hallucinations of people trying to kill her and her family.

Transpose that effect to a war zone, where danger is already acutely felt, and you could see how disastrous consequences could result. It also might explain why this massacre, unlike others in time past, according to Ritchie, did not come as soldiers were being fired on and suffering losses. In his head, Bales might have seen just that.

Ritchie says she has no idea whether Bales was, in fact, given Lariam, but it's one of the things she would look into if she were conducting the psychological evaluation that the soldier will undergo as part of the court martial process.

She says she would also inquire about other possible psychotic-inducing agents. "Afghanistan is on the poppy trade," she observes. And soldiers, even on bases in Iraq and Afghanistan, can get their hands on other illicit drugs. "I've seen soldiers who have gotten methamphetamine sent out to them."

Reports have already emerged of Bales drinking on base, contrary to rules, although defense attorney John Henry Browne has denied that alcohol fueled his client's rampage. In his initial days of defending Bales, before meeting his client, Browne instead called attention to "how we're treating our GI's in general and whether we should be over there to begin with."

Browne met with his client yesterday, and declared that Bates had a memory loss.

So we're obviously a long way from solving the puzzle of how an exceptionally brave soldier could turn into a child-killer, something that his wife yesterday lamented was woefully "out of character." But Ritchie's speculations offer a compelling possible explanation.